Organization
JOHN NIEMELA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D NIEMELA DPM (PHYSICIAN OWNER)
(906) 225-0181
Entity
Organization
Contact information
Practice address
1015 N 3RD ST, SUITE #6, MARQUETTE, MI 49855-3500
(906) 225-0181
(906) 225-0340
Mailing address
1015 N 3RD STREET, STE 6, MARQUETTE, MI 49855-3500
(906) 225-0181
(906) 225-0340
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901002208
MI
335E00000X
Prosthetic/Orthotic Supplier
5901002208
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134882948
—
MI
01
—
4855201230
BCBSM
MI
01
—
4882948
UPPER PENINSULA HLTH PLAN
MI
01
—
510E210880
BCBSM ORTHOTIST
MI
01
—
5901002208
LICENSE
MI
01
—
611477200
US DEPARTMENT OF LABOR
MI
01
—
P00314266
RAILROAD MEDICARE
MI
Enumeration date
11/08/2006
Last updated
03/03/2017
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